糖皮质激素、环磷酰胺联合西地那非用于系统性红斑狼疮合并肺动脉高压患者临床效果观察  

Efficacy of corticosteroids,cyclophosphamide and sildenafil on systemic lupus erythematosus combined with pulmonary arterial hypertension

作　　者：王治国[1] 刘学明[1] 佟胜全[1] 

机构地区：[1]唐山市工人医院,河北唐山063000

出　　处：《山东医药》2016年第28期42-44,共3页Shandong Medical Journal

基　　金：河北省医学科学研究重点课题计划(20150948)

摘　　要：目的观察糖皮质激素、环磷酰胺联合西地那非治疗系统性红斑狼疮合并肺动脉高压（SLE-PAH）的临床效果。方法选择SLE-PAH患者46例,其中轻、中度肺动脉压力组[肺动脉收缩压（PASP）30-70 mmHg]32例,重度肺动脉压力组14例（PASP〉70 mmHg）。两组均给予泼尼松、环磷酰胺联合血管扩张剂西地那非治疗,疗程均为24周。检测两组治疗前后PASP、系统性红斑狼疮疾病活动评分（SLEDAI）、6分钟步行距离、心功能分级,评价治疗效果及不良反应。结果与治疗前比较,两组治疗后NYHA心功能分级均改善,SLEDAI、PASP均降低,6分钟步行距离均增加,同组治疗前后比较P〈0.05或〈0.01。治疗24周,轻、中度肺动脉压力组有效率为87.5%,重度肺动脉压力组为57.1%,两组有效率比较P〈0.05。治疗期间两组不良反应情况比较差异无统计学意义（P〉0.05）。结论糖皮质激素、环磷酰胺联合西地那非治疗SLE-PAH疗效较好,尤其对于PASP轻、中度升高患者疗效明显。Objective To investigate the clinical efficacy of corticosteroids,cyclophosphamide and sildenafil on systemic lupus erythematosus combined with pulmonary arterial hypertension（ SLE-PAH）. Methods Forty-six SLE-PAH patients were selected and divided into two groups： the mild-to-moderate pulmonary artery systolic pressure（ PASP） group（ 32 cases,PASP 30-70 mmHg） and severe PASP group（ 14 cases,PASP 70 mmHg）. Both groups were treated with prednisone,cyclophosphamide and sildenafil,lasting for 24 weeks. PASP,systemic lupus erythematosus disease activity index（ SLEDAI）,6-minute walking distance and New York Heart Association（ NYHA） classification of cardiac function were observed and evaluated. Results NYHA cardiac function improved in both groups after treatment（ P〈0. 01）. Both SLEDAI and PASP were decreased（ P〈0. 05 or P〈0. 01） and 6-minute walking distance was increased（ P〈0. 01）.However,there was no statistical significance in the severe group between before and after treatment（ P〉0. 05）. After 24 weeks treatment,the efficacy rate in the mild-to-moderate PASP group was 87. 5%,and 57. 1% in the severe PASP group（ P〈0. 05）. No significant difference was found in the adverse reactions between these two groups（ P〉0. 05）. Conclusion Corticosteroids,cyclophosphamide and sildenafil have good efficacy on SLE-PAH,especially on those who suffer mild to moderate pulmonary arterial hypertension.

关 键 词：系统性红斑狼疮 肺动脉高压 环磷酰胺 糖皮质激素 西地那非 

分 类 号：R593.24[医药卫生—内科学]